Healthcare Provider Details

I. General information

NPI: 1750123121
Provider Name (Legal Business Name): ICURE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 NEWTOWN AVE FL 1
LONG ISLAND CITY NY
11102-2935
US

IV. Provider business mailing address

2110 NEWTOWN AVE FL 1
LONG ISLAND CITY NY
11102-2935
US

V. Phone/Fax

Practice location:
  • Phone: 718-516-4444
  • Fax: 718-540-7692
Mailing address:
  • Phone: 718-516-4444
  • Fax: 718-540-7692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BOBOJON BOTIROVICH ISAMOV
Title or Position: OWNER
Credential:
Phone: 718-516-4444